Osteoporosis and fractures of the hip, vertebra, or wrist significantly impair the health-related quality of life (HRQOL) of men, according to findings from a systematic review and meta-analysis published in Endocrine.
Osteoporosis in men is an emerging public health issue because of the increased social and economic burdens.
To evaluate the HRQOL of men with osteoporosis, a systematic search was performed using the PubMed, EMBASE, and the Cochrane Library database. In total, 14 studies including 6338 men were identified, of which 10 studies were included in the current review.
Compared with men with normal bone mineral density (BMD), those with osteoporosis had poorer HRQOL. The odds for poorer general health (odds ratio [OR], 3.14; P =.03) and physical function (OR, 3.39; P =.03) were correlated with osteoporosis, even after adjustment for factors such as age, body mass index (BMI), physical activity, social class, cigarette and alcohol consumption, and comorbidities.
The overall HRQOL of men with and without osteoporotic fractures was lower for the fracture group (standard mean difference, -0.53, 95% CI, -1.01 to -0.05); however, there was substantial heterogeneity (I2=95%; P <.01). Hip fracture also significantly impaired HRQOL. Compared with men without a hip fracture, those with a hip fracture had declines in physical and mental function scores within 6 months after the fracture. Vertebral and wrist fractures also led to declines in physical function scores and physical component scores.
Predictors of HRQOL outcomes were femoral and lumbar BMD, time since fracture, and number, type, and severity of fractures. A positive correlation between HRQOL and femoral and lumbar BMD was identified; however, there was a significant negative correlation between the number of fragility fractures or time since fracture and HRQOL. Vertebral fractures appeared to have no prominent effect on HRQOL loss, while health status appeared to gradually decline with time after fracture.
Data on the effects of antiosteoporotic therapy on HRQOL were found to be limited. However, in a 2-year longitudinal study comparing the efficacy of denosumab and alendronate in improving HRQOL of men with osteoporosis and nonmetastatic prostate cancer receiving androgen deprivation therapy, significant improvements were noted after receiving denosumab or alendronate treatment.
Study limitations included the difference in HRQOL questionnaires used for different groups; the small sample size during the evaluation of the impact of osteoporotic fracture on HRQOL; and scarcity of studies on the effects of antiosteoporotic therapy.
According to the study authors, “Large sample studies to evaluate the life quality of men with osteoporosis, especially the effects of anti-osteoporotic treatment on the life quality of men, still need to be carried out.”